APPLICATION FOR RESTAURANT EMPLOYMENT

The TransLatin@ Coalition in Partnership with Michaela Mendelson and The CA Trans Work Project (CTWP) was awarded by The California Workforce Development Board to work with The California Restaurant Association to provide cultural sensitivity training to restaurants across the state of California and place trans people to work at these restaurants that have been trained.

Please fill out this application so that we can set you up for an interview with a restaurant close to your area in the state of California. We will get in contact with you to follow up with your application. Thank you for giving yourself the opportunity to be employed at a restaurant in the State of California.

Preferred Name *

Preferred Name

First Name

Last Name

Legal Name *

Legal Name

First Name

Last Name

Phone *

Phone

(###)

###

####

Email Address *

Present Address *

Present Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Previous Address

Previous Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Age *

If under 18 years of age a work permit or certificate may be required as a condition of employment.

Under 16

Over 17

18 or over

Are you legally authorized to work in the United States? *

If you are hired, you will be required to provide verification of your legal right to work in the United States

Yes

No

How did you learn of our organization

Walk-In

Newspaper

School

Internet

Referral

Agency

Other, please specify below

EMPLOYMENT DESIRED

Position:

Salary Requirements: *

Date you can start: *

Date you can start:

MM

DD

YYYY

Are you available any hours?

If restrictions, indicate available hours below

Days and Hours available to work:

EDUCATION

High School

Graduated

Yes

No

Degree Received

College

Graduated

Yes

No

Degree Received

Business, Trade, Other

Graduated

Yes

No

Degree Received

REFERENCES

List the names of three persons not related to you, whom you have known at least one year

Person 1

Person 1

First Name

Last Name

Phone Number (Person 1)

(###)

###

####

Address (Person 1)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Person 2

Person 2

First Name

Last Name

Phone Number (Person 2)

(###)

###

####

Address (Person 2)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Person 3

Person 3

First Name

Last Name

Phone Number (Person 3)

(###)

###

####

Address (Person 3)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Personal Information

Have you ever been convicted of a crime? *

You need not disclose: 1.) convictions for marijuana-related offenses that are more than two years old; 2.) any information regarding
your participation in or referral to any diversion program; 3.) convictions that have been sealed, expunged or legally eradicated; and 4.) misdemeanor convictions for which probation was completed and the case was dismissed. If yes, briefly describe the nature of the crime(s). the date and place of conviction, and the legal disposition of the case.

A conviction will not necessarily disqualify you from employment.

FORMER EMPLOYERS

List below last two employers, starting with your present or most recent employer.